• The Journal of Internal Korean Medicine
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• v.45 no.3
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• pp.342-357
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• 2024

Background: Cold hypersensitivity (CH) and sleep disorders are not limited to patients with specific diseases, as they are also commonly observed in the general population. The objective of this study was to investigate the relationship between CH and sleep quality. Methods: This cross-sectional study analyzed data from a cohort of 5,052 individuals living in South Korea. Based on the results of a questionnaire on CH, the participants were classified into four groups: non-CH, CH in the hands (CHH), CH in the feet (CHF), and CH in the hands and feet (CHHF). Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). Multiple regression was used for groupwise comparisons of total PSQI scores and the scores for each component, and logistic regression was used to find the odds ratios of being a "poor sleeper" (PSQI≥8.5). Results: The CHF and CHHF groups showed significantly higher scores than the non-CH group on the overall PSQI as well as on the following sleep components: subjective sleep quality, sleep latency, habitual sleep efficiency, sleep disturbance, and sleep medication use. The odds ratios for being a "poor sleeper" were significant in the CHF (1.84; CI=1.38-2.43) and CHHF groups (1.54; CI=1.25-1.89), but the CHH group did not show any difference from the non-CH group. We identified a correlation between CH in the feet and poor sleep quality. Conclusions: These findings help to elucidate the relationship between sleep and CH and highlight the need to clarify the underlying mechanism.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.37 no.4
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• pp.1-12
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• 2024

Objectives: Cold hypersensitivity in the hands and feet(CHHF) is associated with pattern identification such as Yang deficiency or Spleen-stomach deficiency in Korean medicine, and is linked to various diseases and symptoms. This study was conducted as a retrospective cross-sectional study based on a nationwide survey to analyze the relationship between CHHF and subjective hearing discomfort, tinnitus, and hearing loss. Methods: We analyzed data from the Korean National Health and Nutrition Examination Survey V(KNHANES V) conducted from 2010 to 2012. A total of 15,950 participants aged 19 and older who had records of responses to the questionnaires on CHHF, hearing discomfort and tinnitus, as well as pure-tone audiometry results, were included in the study. A complex sample logistic regression analysis was performed to compare the risks of hearing discomfort, tinnitus, and hearing loss between the CHHF group and the non-CHHF group. Results: The CHHF group consisted of 3,622 individuals, representing 22.7% after applying weights. In the logistic regression analysis adjusted for demographic variables, the odds ratio for tinnitus in the CHHF group was 1.493 compared to the non-CHHF group. For hearing discomfort, the odds ratios for "slightly uncomfortable" and "very uncomfortable" were 1.411 and 1.629, respectively, compared to the non-CHHF group. No differences in odds ratios for unilateral and bilateral hearing loss were observed between the groups. Conclusions: These results suggest that CHHF may influence subjective hearing discomfort and tinnitus. Given that this study is a cross-sectional study, further investigations are required to determine causation.

• The Journal of Korean Physical Therapy
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• v.36 no.4
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• pp.145-152
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• 2024

Purpose: This study aimed to investigate the correlation of the flexibility of lumbar muscle fibers with the speed of the broad four-pronged muscle in healthy adult men and women. Methods: This study selected 36 healthy male and female college students. The subjects were randomly assigned to two groups (Group A; performing three stretches, and Group B; not engaging in any stretching) and measured for flexibility, functional evaluation, and biomechanical parameters (CSMI) as pre-experimental evaluation items. Flexibility was evaluated using 2 types of sit and reach tests and Schober's test, while functional evaluation was assessed through the 3-hop test and the Sargent test. The knee extension angular velocities of the biomechanical parameters were measured at 60°, 120°, 180°, and 240° to determine peak torque, work per repetition, and peak power. Results: Group A exhibited statistically significant improvements in both the before and after comparison of the sit and reach test and the difference in the quantum of change. There was a statistically significant improvement in the before and after comparison of the 3-hop jump test and the difference in the quantum of change. As for the isokinetic parameters, the peak torque of 60°, 120°, 180°, and 240° were only all significant in the experimental group. Conclusion: This study focused on assessing the role of the lower extremities with respect to lumbar flexibility. The results suggest that lumbar flexibility has a statistically significant and positive effect on lower extremity flexibility and its function.

• Allergy, Asthma & Respiratory Disease
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• v.12 no.4
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• pp.198-203
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• 2024

Stevens-Johnson syndrome (SJS) and acute generalized exanthematous pustulosis (AGEP) are 2 distinct entities that can overlap within the spectrum of severe cutaneous adverse reaction (SCAR). AGEP is a self-limiting and drug-induced eruption characterized by sudden onset of sterile pustules, erythema, and sometimes fever. SJS, in contrast, is a severe form of SCAR that causes blistering and necrosis of the skin and mucosal membranes, often leading to significant morbidity and mortality. However, there are cases where patients may present with symptoms that overlap between AGEP and SJS, making it challenging to differentiate the 2 conditions. This report describes a 70-year-old male with nontuberculous mycobacterium tenosynovitis in the left hand, coinfected with methicillin-resistant coagulase-negative Staphylococcus and Klebsiella oxytoca. After administration of additional antibiotics, the patient developed fever and erythematous macules with purpuric centers on the trunk and the extremities. Further examination revealed marked leukocytosis and elevated C-reactive protein levels. Skin biopsy histopathology showed subcorneal intraepidermal pustule formation with neutrophil infiltration. The patient's clinical course improved after cessation of the culprit drugs and treatment with a high-dose systemic steroid. This case highlights the rare occurrence of SJS/AGEP overlap and underscores the importance of prompt diagnosis and appropriate management of these SCAR.

• Journal of Radiation Protection and Research
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• v.49 no.3
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• pp.141-150
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• 2024

Background: Computed tomography (CT) scans in the Republic of Korea have spiked, reaching approximately 9 million examinations annually in 2017. CT provides significant medical benefits, but radiation exposure remains a concern. This study aims to analyze CT scans in Korea, as a basis study for radiation safety management. Materials and Methods: The raw data of total CT scans was obtained from the Health Insurance Review & Assessment Service and analyzed by CT scan type, patients' age and sex, and medical facility type. CT scans trends were analyzed considering the disease incidence. Results and Discussion: In 2017, CT scans accounted for 8,977,300. Usage per capita was 0.18 in males and 0.17 in females. CT scans increased with age until the 50- to 59-year-old groups, then decreased. CT scans were high in abdominal/pelvic (35%), chest (26%), and head (22%) regions due to higher disease rates. Head CT was most frequently used for infants and children. Abdominal/pelvic, chest, and spine CT were more frequent for older groups. The CT scans in the upper and lower extremities was high in child and juvenile groups. Chest and abdominal/pelvic CTs were higher in males, whereas spine, whole spine, and CT densitometry were higher in females. The proportion of CT scans of tertiary and general hospitals, hospitals, and clinics accounted for ≥80%, 13%, and 5%, respectively. Abdomen/pelvis, chest, and head/neck CTs were mostly conducted in tertiary and general hospitals, spine CT in hospitals and clinics, extremity CT in hospitals, and CT densitometry in clinics. Conclusion: The trend of CT scans varied based on the incidence rate for each patient's sex and age, and serious illness diagnosis by medical facility type. The results of this study provide data and guidance for evaluating the radiation exposure of the Korean population by CT and developing management policies for medical radiation safety.

• Journal of the Korean Physical Society
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• v.80
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• pp.247-256
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• 2022

Our objective was to investigate radiomics signatures and prediction models defined by four segmentation methods in using 2-[¹⁸F]fluoro-2-deoxy-d-glucose positron emission tomography (¹⁸F-FDG PET) imaging of lung metastases of soft-tissue sarcomas (STSs). For this purpose, three fixed threshold methods using the standardized uptake value (SUV) and gradient-based edge detection (ED) were used for tumor delineation on the PET images of STSs. The Dice coefficients (DCs) of the segmentation methods were compared. The least absolute shrinkage and selection operator (LASSO) regression and Spearman's rank, and Friedman's ANOVA test were used for selection and validation of radiomics features. The developed radiomics models were assessed using ROC (receiver operating characteristics) curve and confusion matrices. According to the results, the DC values showed the biggest difference between SUV40% and other segmentation methods (DC: 0.55 and 0.59). Grey-level run-length matrix_run-length nonuniformity (GLRLM_RLNU) was a common radiomics signature extracted by all segmentation methods. The multivariable logistic regression of ED showed the highest area under the ROC (receiver operating characteristic) curve (AUC), sensitivity, specificity, and accuracy (AUC: 0.88, sensitivity: 0.85, specificity: 0.74, accuracy: 0.81). In our research, the ED method was able to derive a significant model of radiomics. GLRLM_RLNU which was selected from all segmented methods as a meaningful feature was considered the obvious radiomics feature associated with the heterogeneity and the aggressiveness. Our results have apparently showed that radiomics signatures have the potential to uncover tumor characteristics.

• The Journal of Internal Korean Medicine
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• v.45 no.5
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• pp.978-989
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• 2024

Introduction: This report describes a case of locked-in syndrome (LIS) due to a bilateral pontine infarction. Case Presentation: A patient with LIS showed worsening despite treatment with thrombolytics, anticoagulants, and antiplatelet agents for acute pontine infarction. On the 8th day post-infarction, the patient was referred to the Internal Korean Medicine Department and received 83 days of acupuncture therapy. Treatments were conducted daily, excluding holidays and Sundays, for 15 minutes at various acupoints, including Baihui (GV20), Qubin (GB7), Jianyu (LI15), and Hegu (LI4). Muscle strength was assessed using manual muscle testing (MMT). Post-treatment, improvements were observed: right upper extremity strength increased from grades 0 and 1 to 2 and 4, while right lower extremity strength increased from 0 and 0 to 2 and 3; the results were similar for both left extremities. Conclusion: Acupuncture therapy led to a noticeable improvement in muscle strength in the LIS patient.

• Clinical and Experimental Pediatrics
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• v.50 no.6
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• pp.549-555
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• 2007

Purpose : Pulse wave velocity (PWV) and ankle brachial index (ABI) are simple, non-invasive methods to assess arterial stiffness. These parameters are also known to be closely related to cardiovascular risk factors and diseases. The purposes of this study were to measure blood pressure, PWV, ABI in healthy Korean adolescents, set up their normal values and assess their correlations. Methods : Three hundred ninety two healthy adolescents (213 boys and 179 girls) underwent measurement of brachial ankle pulse wave velocity (baPWV), ABI, body mass index(BMI) and blood pressure from four extremities. Linear regression analysis was performed to reveal the correlations between PWV, ABI and independent variables. Results : Blood pressure and PWV were significantly higher in all extremities in males compared to females. Blood pressure of both brachial and ankle showed positive correlation with body weight, height, and BMI, whereas ABI showed no correlation with any of these indices. Conclusion : Blood pressure increases as body weight, height and BMI increases. PWV shows positive correlation with blood pressure. It will be helpful to predict the risks of cardiovascular diseases in adolescents.

• Journal of Chest Surgery
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• v.38 no.12 s.257
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• pp.844-848
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• 2005

Background: Thoracic outlet syndrome(TOS) is caused by the compression of neurovascular structures that supply to the upper extremities. Only a few reports have been published in Korea, and this study attempts to investigate the clinical aspects and results of the patients who underwent surgical treatment. Material and Method: This study consist of 16 patients who underwent operations for thoracic outlet syndrome from May, 2002 to October, 2004. The surgical indications were confined to patients with: 1) symptom too severe to perform ordinary daily life because of pain, paresthesia, edema of upper extremities, 2) no improvement after proper physical therapy, 3) definite finding of compression confined by radiologic examinations (MRI, angiography, etc), and 4) no other diseases such as cervical intervertebral herniation, myositis, neurologic diseases below the brachial plexus. The surgical approaches were by transaxillary approaches in 12 cases, supraclavicular approaches in 2 cases, and infraciavicular approaches in 2 cases. Result: There were 15 males and one female with an average age of 23.9 years (range:19$\∼$39). Rib anomalies were observed in four cases (25.0$\%$), but the others had no abnormal ribs. Right lesions were found in eight cases (50.0$\%$), left lesions in five cases (31.3$\%$), and bilateral lesions in three cases (18.7$\%$). The follow-up period was 9$\∼$26 months and recurrence rate was 12.5$\%$ (2/16). Complications were one case of ulnar nerve palsy, one case of persistent pain despite radiologic improvement and three cases of wound dehiscence due to fat necrosis and hematoma. Conclusion: Although the choice of treatment in patients with TOS has been disputed, patients who have no response with proper physical therapies can benefit from the surgical treatment which may help patients to return to normal daily activity in shorter period of time.

• Journal of Chest Surgery
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• v.38 no.8 s.253
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• pp.557-563
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• 2005

Background: Recently 980-nm diode laser endovenous treatment was introduced and used as a method of treatment for varicose vein in lower extremities. The advantages of endovenous laser treatment are good cosmetic effects without incision and avoidance of complications associated with surgery. Therefore, we performed an endovenous laser treatment using a 980-nm diode laser and observed the effects and the efficiency of treatment. Material and Method: From October, 2003 to March, 2004, 55 patients (84 limbs) underwent endovenous laser treatment with a 980-nm diode laser. The effects of treatment, complications and recurrences were reviewed. Result The mean age of patients was 47.2 years old and the number of men and women were 2f and 35. In a total of 84 limbs, postoperative complications were transient ecchymosis(84 cases), local paresthesia (24 cases), local skin discolorization (6 cases), minimal burn (3 cases), and post operative phlebitis (1 cases). Adjuvant sclerotherapy was performed in 27 limbs and it was performed in varicose veins missed at operation and varicose veins remaining after endovenous laser treatment. In a total of 56 patients, 2 patients $(3.57\%)$ had recurrences after endovenous laser treatment and were treated with phlebectomy. Conclusion: Our findings demonstrated that 980-nm endovenous laser treatment had good cosmetic results with acceptable complications. This study was based on short-term results and long term follow-up is necessary to evaluate the accurate effects of treatment and recurrence. We think that multimodality treatment with endovenous laser treatment including phlebectomy or transilluminated powered phlebectomy can help decreasing of recurrence especially in patients with tortuous varicose cluster.